摘要
目的 探究CT形态学特征及定量参数在预测急性胰腺炎(AP)严重程度和住院时间的价值。方法 回顾性收集76例AP,在CT图像上评估多种形态学特征,同时测量胰腺头、体、尾前后径。采用χ2检验或Fisher精确检验比较分类变量组间差异,Mann-Whitney U检验比较定量参数组间差异。采用ROC曲线评估诊断效能。结果 胰周脂肪浑浊、胰周积液、积液范围、胸腹壁水肿、胸腔积液和肺部膨胀不全在不同严重程度组间均存在显著差异(P值均<0.05)。重症AP的胰头前后径显著高于非重症AP(P=0.041)。胰头前后径联合CT形态学特征预测重症AP的AUC值为0.866。肾前筋膜增厚、积液范围、胸腹壁水肿、胸腔积液和肺部膨胀不全在不同住院时间组间均存在显著差异(P值均<0.05)。多参数模型预测AP住院时间的AUC值为0.770。结论 CT形态学征象联合胰腺前后径预测重症AP诊断效能良好。这可能为临床早期评估AP严重程度并调整诊疗方案提供一定的参考价值。
Objective To explore the value of computed tomography(CT) morphological features in predicting the severity and length of hospital stay of acute pancreatitis(AP). Methods A total of 76 cases of AP were retrospectively collected. Multiple morphological features on CT images were evaluated,and the pancreatic anterior-posterior diameters in the head,body,and tail were also measured. The difference of categorical variables was used Chi-square test or Fisher’s exact test,and the difference of quantitative data was analyzed by the Mann-Whitney U test. Receiver operating characteristic(ROC)curves were performed to identify the diagnostic performance of parameters. Results There were significant differences in CT morphological characteristics between different AP severity groups,such as peripancreatic fat turbidity,peripancreatic fluid collection,wide range of fluid,chest and abdominal wall edema,pleural effusion,and atelectasis(all P<0.05). The anterior-posterior diameter of pancreatic head of severe AP was significantly higher than that of non-severe AP(P=0.041). The area under the ROC curve(AUC) of anterior-posterior diameter of pancreatic head combined with CT morphological features for predicting severe AP was 0.866. CT morphological characteristics between groups with different length of hospital stay had significant differences,such as renal fascia thickening,wide range of fluid,chest and abdominal wall edema,pleural effusion,and atelectasis(all P<0.05). The AUC of the multi-parameter model was 0.770 in predicting hospital stay of AP. Conclusions A combination of the CT morphological features and anterior-posterior diameter of pancreas showed higher diagnostic performance in predicting severe AP. It may provide a certain reference for the early clinical evaluation of severe AP and the adjustment of the treatment plan.
作者
孙双双
刘松
朱小倩
张松
冯永静
周正扬
SUN Shuang-shuang;LIU Song;ZHU Xiao-qian;ZHANG Song;FENG Yong-jing;ZHOU Zhengyang(Department of Radiology,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu Province,China;Department of Gastroenterology,Nanjing Drum Tower Hospital,The Affiliated Hospital of Nanjing University Medical School,Nanjing 210008,Jiangsu Province,China)
出处
《中国CT和MRI杂志》
2023年第2期117-120,共4页
Chinese Journal of CT and MRI
